Newson Clinic

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved patients in decisions about their care and treatment and provided them with advice and support. Staff routinely reviewed patients care and worked with other services to achieve this.At our last assessment, we rated this key question as Good. At this assessment, we rated this key question Outstanding.

This service scored 88 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service demonstrated an exemplary and comprehensive approach to assessing patients’ needs. A robust registration process, supported by a detailed pre‑appointment questionnaire, enabled staff to identify individual patient needs, relevant medical history, and potential risks well in advance of each consultation.

Patients were encouraged to outline three personal goals for their appointment, ensuring these priorities were explicitly explored and addressed during their consultation. Staff explained that this process strengthened shared understanding between doctor and patient and ensured care was truly aligned with patients’ expectations.

Patients’ needs were consistently reviewed at every follow‑up appointment, supported by the routine use of a symptom‑severity questionnaire. The routine use of symptom-severity questionnaire demonstrated the service’s commitment to continuous evaluation. It enabled clinicians to effectively monitor progress and tailor treatment based on measurable outcomes. Between appointments, patients were also able to email or phone the service to seek advice or raise concerns promptly.

We found staff were highly engaged and enthusiastic about delivering holistic care. They emphasised that hormonal changes can affect every aspect of a woman’s health, and therefore comprehensive assessment was essential. In addition to blood tests that helped clinicians understand hormone levels and overall health, the service had invested in Dual‑Energy X‑ray Absorptiometry (DEXA) technology. DEXA scanning offers a non‑invasive and highly accurate method for evaluating body composition, including fat and lean muscle mass, as well as bone mineral density. The investment in this technology demonstrated the service's commitment to comprehensive assessments for patients.

For patients with more complex needs, clinicians proactively discussed cases with colleagues during multi‑disciplinary meetings, ensuring each patient received the most appropriate and effective treatment plan.

The vast majority of patient feedback gathered during this assessment was overwhelmingly positive. Patients consistently reported that the care they received from Newson Clinic had significantly enhanced their wellbeing and, in many cases, markedly improved their overall quality of life.

The service had systems and processes in place to ensure clinicians were up to date with national legislation, evidence-based good practice and required standards. Leaders told us their clinicians were confident in the prescribing of medicines for patients by consulting global research as well as National Institute for Health and Care Excellence (NICE) guidance. For example, leaders told us they also utilised ‘PubMed’ to keep up to date. PubMed is a free, online resource supporting the search and retrieval of science literature with the aim of improving health. Guidance and research were communicated with staff via email updates and meetings. Leaders were enthusiastic about the varied health benefits of taking HRT identified by global research to protect patients’ future health such as cardiovascular health and osteoporosis.

We discussed with staff about the prescribing of high doses of HRT. Clinicians told us they prescribed the lowest dose they possibly could of HRT in order to control and treat patient symptoms effectively. Clinicians explained higher doses were sometimes prescribed for patients as a result of a skin absorption problem.

The service used a ‘symptom severity’ questionnaire to identify symptoms being experienced by patients and their intensity. This questionnaire was repeated to benchmark patient progress with treatment. The service also collated data from the symptom severity questionnaire for research and education purposes.

Staff told us the service had a ‘3 consultation rule’ in place where if a patient had been seen 3 times and no progress for the patient had been made with their symptoms, the clinician was instructed to discuss the patient’s care with a senior clinician for a second opinion.

The service was committed to working collaboratively with healthcare providers to ensure patients received high levels of care. We saw there were robust processes in place for the service to engage with the patients’ NHS GP and wider healthcare team as required.

As part of the registration process, patients were asked to consent for the service to share information with their NHS GP. With patient consent, the service wrote to the patient’s GP and shared what was discussed, what actions took place, and any suggested medication changes if appropriate.

Staff explained if a patient did not consent to sharing information, they checked this at each subsequent appointment and discussed with patients the importance of involving their NHS GP in their care and treatment with the service. They also recorded this decision within the patients record and risk assessed this decision. Staff told us the majority of patients did consent to information sharing and they also found that patients who initially declined, often changed their minds and consented at a later date.

For patients who did not have an NHS GP or lived abroad, they were able to use the consultation summary letter provided for them by the service following their appointment to share with their relevant healthcare professional.

Staff recognised the importance of strong relationships with external healthcare providers to ensure continuity of care and smooth referral processes for patients. Clinicians explained they worked regularly with NHS GPs, Oncologists, Gynaecologists and Breast Cancer Care teams. Leaders told us they had referral pathways in place throughout the UK.

Staff demonstrated they were dedicated to improving the health and wellbeing of women. Staff believed ‘the journey to better hormone health should be a holistic one.'

Clinicians discussed lifestyle, nutrition, exercise, restorative sleep, vitamin D supplementation, bone health, pelvic floor exercises, and social connections with patients as part of their consultation as standard. Within patient letters, the service also provided information about health promotion. The service also offered patients additional services such as bone density scans and contraception services.

In addition to the services provided for patients through the clinic, Newson Clinic had developed the ‘Balance’ software application programme which is free to both patients and the public worldwide and provides medically approved resources to educate and enable people to make informed choices about their health during perimenopause and menopause. The app offers people symptom trackers, community support and evidence-based information on menopause hormone deficiency.

The Balance app is the first menopause support app certified by the digital health organisation, ORCHRA, who review and approve health apps for the NHS and multiple national health bodies around the world. In addition, the app was awarded the ‘Apple’s Editors’ Choice Award.’ This award celebrates exceptional quality, innovation, design, and user experience.

Since August 2024, the service had been working with the United Nations Population Fund (UNPFA) to produce 10 co-branded articles to feature in the Balance app. The UNPFA is a specialised agency within the United Nations that focuses on sexual health, reproductive health, gender equality, and population issues. The UNPFA have regional offices in Africa, Arab States, Asia and the Pacific, Eastern Europe and Central Asia, and Latin America and the Caribbean. The first 5 co-branded articles were published in September 2024. The articles were entitled: ‘Common side effects of menopause;’ ‘Menopause and contraception;’ ‘Perimenopause and menopause basics;’ ‘What are hormones?’ and ‘What to know about cervical screening.’ Between September 2024 and May 2025 there had been 25,000 views of the articles online.

In addition to the UNPFA, the service had also worked with the Sophia Forum organisation which promotes and advocates for the rights, health, welfare and dignity of women living with HIV. The service and the Sophia Forum organisation collaborated to write booklets about HIV and menopause which have now been translated into 22 African languages.

The service actively monitored patients care and treatment to continuously improve it. Staff endeavoured to ensure that outcomes were positive and consistent, and that they met both the clinical expectations and the expectations of patients.

The service had a comprehensive audit schedule covering various clinical and non-clinical areas of the service to drive improvements. Learning from audits was communicated and shared with staff.

We discussed and reviewed three clinical audits which were repeated on a quarterly basis to monitor and assess performance. These were audits on testosterone, progesterone, and high dose oestrogen prescribing. The testosterone audit included checking that testosterone baseline blood tests were repeated for patients at 3 to 6-month intervals after commencing treatment. The progesterone compliance audit included checking if any patients were requesting oestrogen medication only without progesterone. The high dose oestrogen prescribing audit included checking that clinicians were following the clinical pathway which involves ensuring patients received an annual oestradiol level blood test and an annual review.

In addition to the scheduled audits, the service collated and analysed the data for patients who completed their follow up symptom severity questionnaire. This questionnaire tracks patients’ symptom progress before treatment and after. We reviewed the data the service had compiled in one study of 674 patients which identified for all symptoms the average severity score for patients reduced from 86.2% to 56.8%. This was a 34.1% reduction in symptom severity reported by patients. The average follow up period for patients is 3 months.

Another study on patient outcomes found a reduction in symptoms from before treatment to after two appointments with service. For example, symptoms of fatigue were reduced from 96% to 38%; problems with concentration reduced from 91% to 34%; joint pain reduced from 88% to 41%; memory problems reduced from 93% to 44%; issues with sleep reduced from 89% to 27%; and anxiety reduced from 79% to 18%. This study was based on data collated from 20,763 patients.

In addition to the audit schedule, the service had active and frequent participation in research initiatives and peer reviewed publications. For example, in one study published in the Journal of Sexual Medicine in April 2025, 35% of women treated reduced their dose of opioid painkillers; 29% discontinued their use of opioid painkillers; and 26% of women using antidepressants or anxiolytics (medicines used to treat anxiety, fear and tension) reduced or discontinued their use of these medicines after starting HRT.

The results of CQC collated data of patient feedback for this assessment showed 88% of patients were positive about their experience of using Newson Clinic; 8% reported a negative experience; and 4% reported a mixed experience with both positive and negative aspects. The vast majority of patients told us the outcome of their treatment had improved their overall health, wellbeing, and quality of life. Patients expressing negative experiences were unhappy with the outcomes of their treatment. Some patients told us they had experienced negative side effects including heavy bleeding, and some patients felt their medication had promoted cancer.

The service told patients about their rights around consent and respected these when delivering person-centred care and treatment. A consent policy was in place to ensure appropriate consent was obtained from patients when receiving care and treatment. Staff understood the requirements of legislation and guidance when considering consent and decision making. Mental Capacity Act training was mandatory for all clinical staff.

As part of the registration with the service, patients were asked for their consent for the service to share information about their care and treatment with their NHS GP. For patients who declined, clinicians discussed this with them at each appointment and staff told us patients who previously declined often changed their minds later on after receiving treatment and discussing the benefits of sharing information. All patients however were provided with summary letters of their consultations which was theirs to share with healthcare professionals as they wished after their appointment.

Patients were offered a chaperone for care and treatment when this was appropriate such a Mirena coil fittings, ultrasound scans and DEXA scans. Chaperone information was on display to inform patients of this service and staff who provided this service had completed chaperone training.

There was clear information on the service’s website with regards to how the service worked. Information about the cost of the consultation was known in advance and paid for before the appointment started and subsequent costs of prescriptions and additional services such as DEXA scans were communicated.